Although the question of diagnosis of appendicitis is treated as an easy matter by the majority of writers, it still remains of extreme difficulty, owing to the varying data of a given case. Appendicitis is not a self-limited disease, presenting a typical course; it is an anomalous disease.
The following points, gathered by the writer from notes in his own work, point to the extreme care which a case may demand in its diagnosis and subsequent management.
LOCATION OF APPENDIX.
The appendix is not always located in the right iliac region. Twice it was found adherent to the liver; once to the gall-bladder; twice to the urinary bladder. In very stout patients a certain degree of enteroptosis is present and changes materially the location of the appendix. One may then expect to find itin any part of the abdominal cavity, according to the particular location in which the ileocecal region
LAPLACE E. ANOMALIES OF APPENDICITIS.. JAMA. 1902;XXXIX(24):1508–1514. doi:10.1001/jama.1902.52480500014002b
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